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Genetic Biomakers: the Promising Tools in the Diagnosis and Manage of Headache Cases
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Atypical Presentation of Idiopathic Intracranial Hypertension Simulating Demyelinating Disease of the Central Nervous System
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"I don\u27t just have a pain in my neck or just a migraine": Perceptions of migraine patients with neck pain
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Association of altered serum glucose and lipid profiles with headaches in young women: clinical, cross-sectional study
No full textIntroductionHeadaches, including migraines and tension headaches, affect millions of people globally. Migraines are the most common neurological disorder, with around 14.4% of the world\u27s population affected. It is suggested that dysregulation of biochemical markers and individual metabolic differences may contribute to headaches.ObjectiveWe evaluated the frequency of headaches or migraines with changes in lipid, glucose and vitamin D serum levels in young women.MethodsClinical, cross-sectional study with 139 young women, aged at least 18 years, based on the third edition of the International Classification of Headache Disorders (ICHD-3). The individuals were divided into two groups: one without headache and another with headache. Anthropometric analyzes (BMI, WC, BP and DBP) and blood samples were collected for analysis of vitamin D, glycemia and lipid profile.ResultsMean age was 22 (±4.6) years. We observed associations between headache and the following factors: high glucose levels (97 mg/dL, p=0.028), total cholesterol (180.4 mg/dL, p=0.002), HDL (44.2 mg/dL, p=0.017), and LDL (121.6 mg/dL, p=0.005). Longer duration of headache attacks was associated with increased levels of glucose (97.9 mg/dL, p=0.028), total cholesterol (186.8 mg/dL, p=0.05), diastolic blood pressure (74 mmHg, p=0.038), and BMI (24.6 kg/m2, p=0.024). High glucose levels were found to be directly related to the presence of migraine, particularly those with aura (105 mg/dL, p=0.034). However, there was no significant difference in vitamin D levels (p=0.640). ConclusionElevated levels of blood glucose and total plasma cholesterol and its fractions seems to be associated can increase with bouts of headache attacks, especially migraine, prolonging the duration of pain.Introdução: as dores de cabeça, incluindo enxaquecas e dores de cabeça tensionais, afetam milhões de pessoas em todo o mundo. As enxaquecas são o distúrbio neurológico mais comum, afetando cerca de 14,4% da população mundial. Sugere-se que a desregulação dos marcadores bioquímicos e as diferenças metabólicas individuais possam contribuir para as dores de cabeça. Objetivo: avaliar a frequência de cefaleias ou enxaquecas com alterações nos níveis séricos de lipídios, glicose e vitamina D em mulheres jovens. Métodos: estudo clínico, transversal, com 139 mulheres jovens, com idade mínima de 18 anos, baseado na terceira edição da Classificação Internacional de Cefaleias (ICHD-3). Foram coletadas análises antropométricas (IMC, CC, PA e PAD) e amostras de sangue para análise de vitamina D, glicemia e perfil lipídico. Resultados: a média de idade foi de 22 (+4,6) anos. Observamos associações entre cefaleia e os seguintes fatores: níveis elevados de glicose (97 mg/dL, p=0,028), colesterol total (180,4 mg/dL, p=0,002), HDL (44,2 mg/dL, p=0,017) e LDL (121,6 mg/dL, p=0,005). A maior duração das crises de cefaleia foi associada ao aumento dos níveis de glicose (97,9 mg/dL, p=0,028), colesterol total (186,8 mg/dL, p=0,05), pressão arterial diastólica (74 mmHg, p=0,038) e IMC (24,6kg/m2, p=0,024). Verificou-se que níveis elevados de glicose estão diretamente relacionados à presença de enxaqueca, principalmente naqueles com aura (105 mg/dL, p=0,034). Entretanto, não houve diferença significativa nos níveis de Vitamina D (p>0,640). Conclusão: níveis elevados de glicemia e colesterol plasmático total e suas frações parecem estar associados e podem aumentar com crises de cefaleia, principalmente enxaqueca, prolongando a duração da dor.
 
Calcitonin gene-related peptide (CGRP) concentrations outside migraine attacks in peripheral blood as a potential biomarker for chronic migraine
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Introduction
Chronic migraine is a debilitating condition that affects a significant portion of the population. Accurate diagnosis and treatment of chronic migraine remain a challenge due to the lack of objective biomarkers. Calcitonin gene-related peptide (CGRP) is a neuropeptide involved in the pathophysiology of migraine and has been proposed as a potential biomarker for migraine.
Methods
We measured CGRP levels in peripheral blood samples collected from 142 participants with chronic or episodic migraine and 24 healthy controls during ictal periods, i.e., outside migraine attacks. We compared CGRP levels between the three groups and assessed the correlation between CGRP levels and clinical features of chronic migraine.
Conclusion
Our study provides evidence that CGRP levels in peripheral blood during ictal periods may serve as a potential biomarker for chronic migraine. Further studies are needed to validate these findings and to explore the clinical utility of CGRP as a biomarker for chronic migraine
Presença de mastócitos no pericrânio de rato – um tecido muito sensível à dor
No full textObjectiveTo evaluate mast cell presence in the pericranium of Wistar rats.MethodsFive male rats of the Wistar strain were used. The animals were housed under a 12 h light cycle with ad libitum access to food and water and allowed 10 days of acclimatization before tissue sampling. The five rats were anesthetized by intraperitoneal injection of ketamine/xylazine, 10/20 mg/kg. Following aseptic preparation of the head skin, a midline longitudinal incision was made to expose the pericranium. Two samples of the pericranium were taken, one from the right and one from the left. These samples were fixed in 10% buffered formaldehyde for 24 h. After fixation, tissue samples were paraffin-embedded and sectioned at 4 μm. Then, slides were deparaffinized, stained with a concentration of 0.1% toluidine blue for 1 min, and washed with distilled water. Last, slides were photomicrographed under 400x magnification to identify mast cells.ResultsMast cells were identified in the dura mater and the five rats\u27 pericranium. In the dura mater, mast cells were also found in these rats. We found both granulated (intact) and degranulated mast cells.ConclusionWe suggest that future preclinical studies investigating the involvement of dural mast cells and other meningeal cell populations should also include pericranium samples to explore this structure\u27s relevance in migraine pain and other headache disorders.ObjetivoAvaliar a presença de mastócitos no pericrânio de ratos Wistar.MétodosForam utilizados cinco ratos machos da linhagem Wistar. Os animais foram alojados sob um ciclo de luz de 12 h com acesso ad libitum a comida e água e permitiram 10 dias de aclimatação antes da amostragem de tecido. Os cinco ratos foram anestesiados por injeção intraperitoneal de cetamina/xilazina, 10/20 mg/kg. Após a preparação asséptica da pele da cabeça, uma incisão longitudinal mediana foi feita para expor o pericrânio. Foram colhidas duas amostras do pericrânio, uma à direita e outra à esquerda. Essas amostras foram fixadas em formaldeído tamponado a 10% por 24 horas. Após a fixação, as amostras de tecido foram embebidas em parafina e seccionadas a 4 μm. Em seguida, as lâminas foram desparafinizadas, coradas com azul de toluidina a 0,1% por 1 min e lavadas com água destilada. Por fim, as lâminas foram fotomicrografadas com aumento de 400x para identificação dos mastócitos.ResultadosMastócitos foram identificados na dura-máter e no pericrânio de cinco ratos. Na dura-máter, mastócitos também foram encontrados nesses ratos. Encontramos mastócitos granulados (intactos) e degranulados.ConclusãoSugerimos que futuros estudos pré-clínicos que investiguem o envolvimento de mastócitos durais e outras populações de células meníngeas também incluam amostras de pericrânio para explorar a relevância dessa estrutura na dor da enxaqueca e outras cefaleias
Reação de hipersensibilidade atípica à injeção de toxina botulínica
No full textBotulinum toxin type A (BTA) injection, marketed as BOTOX, is commonly used as a treatment for a variety of clinical indications and is widely viewed as safe, effective and largely devoid of serious side effects. Anaphylactic reactions to BTA are typically unheard of in the scientific literature. BOTOX is approved by the Food and Drug Administration for the treatment of cervical dystonia and prophylaxis for chronic migraines. This case report documents a unique instance of allergic reaction to BTA in a 29-year-old woman with cervicogenic headache and cervical dystonia who reported immediate flushing, light-headedness and nausea after receiving BTA injections. A injeção de toxina botulínica tipo A (BTA), comercializada como BOTOX, é comumente usada como tratamento para uma variedade de indicações clínicas e é amplamente considerada segura, eficaz e amplamente desprovida de efeitos colaterais graves. As reações anafiláticas ao BTA são tipicamente inéditas na literatura científica. BOTOX é aprovado pela Food and Drug Administration para o tratamento da distonia cervical e profilaxia para enxaquecas crônicas. Este relato de caso documenta um caso único de reação alérgica ao BTA em uma mulher de 29 anos com dor de cabeça cervicogênica e distonia cervical que relatou rubor imediato, tontura e náusea após receber injeções de BTA
Cefaleia por compressão externa durante a pandemia de Covid-19: uma entidade negligenciada
No full textIntroductionPersonal Protective Equipment (PPE) is part of the work routine of health professionals, especially during pandemics. During the Covid-19 pandemic, the use of PPE became constant for long working hours, resulting in adverse effects on the health of professionals, especially headache.ObjectiveIn this review, we explore the scientific literature on headache associated with prolonged use of PPE during the coronavirus pandemic.MethodThis is a narrative literature review conducted through the PubMed and Web of Science databases according to the following MeSH descriptors: “Face shield”, “Headache” and “Covid-19”. Articles that analyzed the presence of headache and other adverse events in health professionals in prolonged use of PPE were included.ResultsThe included studies point to headache as the most prevalent adverse event, which may be a new headache or the worsening of a previous headache. Other effects were also found, such as pressure marks on the skin, hyperemia in contact areas; suffocation; reduced concentration and excessive sweating.ConclusionThe use of PPE for long periods can cause headaches due to external pressure, in addition to other unwanted events.These effects reveal the importance of studies to make PPE more efficient, ensuring protection for the individual without causing discomfort.IntroduçãoOs Equipamentos de Proteção Individual (EPI) fazem parte da rotina de trabalho dos profissionais de saúde, principalmente durante as pandemias. Durante a pandemia de Covid-19, o uso de EPI tornou-se constante por longas jornadas de trabalho, resultando em efeitos adversos à saúde dos profissionais, principalmente cefaleia.ObjetivoNesta revisão, exploramos a literatura científica sobre a cefaleia associada ao uso prolongado de EPI durante a pandemia de coronavírus.MétodoTrata-se de uma revisão narrativa da literatura realizada nas bases de dados PubMed e Web of Science de acordo com os seguintes descritores MeSH: “Face shield”, “Headache” e “Covid-19”. Foram incluídos artigos que analisaram a presença de cefaleia e outros eventos adversos em profissionais de saúde sob uso prolongado de EPI.ResultadosOs estudos incluídos apontam a cefaleia como o evento adverso mais prevalente, tanto o surgimento de uma nova cefaleia quanto o agravamento de uma cefaleia anterior. Outros efeitos também foram encontrados, como marcas de pressão na pele, hiperemia nas áreas de contato; sufocamento; concentração reduzida e sudorese excessiva.ConclusãoO uso de EPI por longos períodos pode causar dores de cabeça por compressão externa, além de outros eventos indesejados. Esses efeitos revelam a importância de estudos para tornar o EPI mais eficiente, garantindo proteção ao indivíduo sem causar desconforto.
Impulsivity in migraine and in medication overuse headache: A literature review
Get PDFIntroductionPsychiatric symptoms and analgesic overuse may contribute to migraine chronification. Impulsivity is a common symptom in several psychiatric disorders that can potentiate substance overuse, including analgesics. Dopamine has been associated with migraine pathophysiology and impulsivity.ObjectiveThis review aims to assess the current knowledge about the potential association between migraine and impulsivity.MethodsPubMed and LILACS were queried using relevant descriptors related to migraine and impulsivity.ResultsFive articles were selected; however, none revealed a significant correlation between migraine and impulsivity. This lack of correlation was verified in different migraine subtypes (with or without aura, chronic, or episodic).ConclusionThe heterogeneity in patient grouping and diverse impulsivity assessment tools of the studies precluded definitive conclusions. The Barratt Impulsivity Scale (BIS-11) was the most frequently used tool. Given the paucity of data and the potential impact on migraine management, further studies are crucial to elucidate the potential association between migraine and impulsivity.
